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Your Major Shoulder Surgery: What to Expect

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This leaflet explains what happens before, during, and after your major shoulder surgery, focusing on the anaesthesia you’s receive. We want you to feel informed and comfortable. Major shoulder surgery can be complex, and we’ve designed this to help you understand what to expect.

1. About Your Surgery

Major shoulder surgery often involves complex repairs or reconstructions of the shoulder joint. This might include:

  • Complex Rotator Cuff Repairs: Repairing large or irreparable rotator cuff tears.
  • Shoulder Instability Surgery: Addressing recurrent dislocations or instability.
  • Revision Shoulder Surgery: Correcting previous shoulder surgeries.
  • Fracture Repair: Stabilizing and repairing complex shoulder fractures.

2. Before Your Surgery: Getting You Ready

Your anaesthetist is a vital part of your surgical team. We want to ensure you’s in the best possible condition for surgery, especially given the complexity of the procedure.

  • Pre-Anaesthetic Consultation: You’s likely to have a thorough consultation with your anaesthetist. This typically lasts 30-60 minutes and might be in person or via telehealth. This allows us to discuss your medical history, medications, allergies, and any concerns you may have. We’re likely to ask more detailed questions about your overall health and previous surgical experiences.
  • Medical History Review: We need a complete picture of your health. This may involve:
    • Reviewing your medical records (allow 1-2 weeks for this process).
    • Ordering blood tests or other investigations (results typically available within 2-5 business days).
    • Consultations with other specialists (e.g., cardiologist, pulmonologist, diabetes educator) – timing varies depending on specialist availability.
  • Timing: Due to the complexity of major shoulder surgery, there may be a longer wait time between your consultation and your surgery date. This typically ranges from 2-8 weeks, allowing for careful planning and optimization of your health.
  • Important! Notify your anaesthetist immediately if you develop any new medical conditions or take any new medications between your consultation and your surgery date.
  • Smoking Cessation: If you smoke, stopping as far in advance of surgery as possible is strongly recommended. Aim to stop at least 4-6 weeks before surgery.

3. Fasting: Preparing Your Stomach

Fasting (not eating or drinking) is crucial for your safety under anaesthesia.

  • No Food: You must not eat anything for 6 hours before your scheduled surgery time.
  • No Clear Liquids: You must not have any clear liquids (water, juice, tea, coffee, clear broths) for 2 hours before your scheduled surgery time.
  • Your anaesthetist will confirm these timings with you.

4. What to Expect During Your Surgery: Anaesthesia Options

Your anaesthetist will discuss the best type of anaesthesia for you, considering the type of surgery, your health, and your preferences. Given the length and complexity of major shoulder surgery, general anaesthesia is often preferred.

  • Regional Anaesthesia (Nerve Block): While possible, regional anaesthesia may not be suitable for all major shoulder procedures due to the length of the surgery and the need for complete muscle relaxation.
  • General Anaesthesia ("Going to Sleep"):
    • Arrival at Hospital: Plan to arrive at the hospital 2-3 hours before your scheduled surgery time.
    • Pre-operative Assessment: Expect a brief assessment by the anaesthetist 1-2 hours before surgery.
    • Surgery Duration: The surgery itself typically lasts 2-4 hours, but can be longer depending on the complexity.
    • Recovery Room Stay: You’ll spend approximately 1-2 hours in the recovery room after the surgery.

5. After Your Surgery: What to Expect

  • Drowsiness: It’s normal to feel drowsy as you wake up from anaesthesia. This can last for a significant portion of the day.
  • Pain Management: Pain management is a priority. You may receive multiple pain medications, including those administered through a patient-controlled analgesia (PCA) pump.
  • Regional Anaesthesia: If you had a nerve block, your arm may feel numb or weak. This is temporary. Rarely, there may be numbness or weakness in your face.
  • Pain & Nausea: You may experience some discomfort, pain, or nausea. Medications will be available to help manage these.
  • Sore Throat/Headache: A dry or sore throat, or headache, are common and usually resolve within 1-2 days.
  • Hospital Stay: You can generally expect a longer hospital stay (typically 2-5 days or longer) to allow for adequate pain management, monitoring, and rehabilitation.
  • Rehabilitation: A comprehensive rehabilitation program is essential for a successful recovery. Expect physical therapy sessions 3-5 times per week for several months.
  • Going Home: You must have a responsible adult with you for several days after you return home.

6. Important Safety Information

  • Do Not:
    • Drink alcohol
    • Drive a car
    • Operate machinery For at least 24 hours after receiving anaesthesia.
  • Medications: Specific instructions will be given regarding blood thinners and diabetic medications. If you’s unsure, ask your surgeon or anaesthetist.

7. Potential Risks

Major shoulder surgery carries a higher risk of complications compared to less complex procedures. These risks will be discussed in detail with your surgical team.

  • Common Minor Risks: Bruising, fatigue, sore throat, headache, sleep disturbances, muscle aches, nausea, and vomiting.
  • Rare but Serious Risks: Infection, blood clots, nerve damage, lung complications, allergic reactions, and, in extremely rare cases, death.

8. PCA (Patient-Controlled Analgesia)

In most cases, you will be offered PCA. This is a device that allows you to administer small doses of pain medication yourself, within a safe and controlled manner. Your nurse will explain how it works and answer any questions you may have.

9. Frequently Asked Questions (FAQ)

  • Q: How long will I be in the hospital?
    • A: Hospital stays for major shoulder surgery are typically longer, ranging from 2 to 5 days or longer, depending on the complexity of the procedure and your overall health.
  • Q: What is the recovery process like?
    • A: Recovery from major shoulder surgery is a gradual process that requires dedication to a rehabilitation program. It can take several months to regain full function.
  • Q: Will I be able to drive again soon?
    • A: Driving is typically restricted for several weeks or months after surgery.

Glossary

  • Anaesthetist: A medical doctor specializing in anaesthesia.
  • Anaesthesia: A medical technique to prevent pain during surgery.
  • Cannula: A small, flexible tube inserted into a vein.
  • Nerve Block: A type of regional anaesthesia.
  • PCA: Patient-Controlled Analgesia.
  • Regional Anaesthesia: Anaesthesia that numbs a specific area of the body.